The utility of Xpert MTB/RIF performed on bronchial washings obtained in patients with suspected pulmonary tuberculosis in a high prevalence setting
| dc.contributor.author | Barnard, Dewald A. | en_ZA |
| dc.contributor.author | Irusen, Elvis M. | en_ZA |
| dc.contributor.author | Bruwer, Johannes W. | en_ZA |
| dc.contributor.author | Plekker, Dante | en_ZA |
| dc.contributor.author | Whitelaw, Andrew C. | en_ZA |
| dc.contributor.author | Deetlefs, Jacobus D. | en_ZA |
| dc.contributor.author | Koegelenberg, Coenraad F. N. | en_ZA |
| dc.date.accessioned | 2016-11-01T09:19:58Z | |
| dc.date.available | 2016-11-01T09:19:58Z | |
| dc.date.issued | 2015-09-16 | |
| dc.description | CITATION: Barnard, D. A. et al. 2015. The utility of Xpert MTB/RIF performed on bronchial washings obtained in patients with suspected pulmonary tuberculosis in a high prevalence setting. BMC Pulmonary Medicine, 15:103, doi:10.1186/s12890-015-0086-z. | |
| dc.description | The original publication is available at http://bmcpulmmed.biomedcentral.com | |
| dc.description.abstract | Background: Xpert MTB/RIF has been shown to have a superior sensitivity to microscopy for acid fast bacilli (AFB) in sputum and has been recommended as a standard first line investigation for pulmonary tuberculosis (PTB). Bronchoscopy is a valuable tool in diagnosing PTB in sputum negative patients. There is limited data on the utility of Xpert MTB/RIF performed on bronchial lavage specimens. Our aim was to evaluate the diagnostic efficiency of Xpert MTB/RIF performed on bronchial washings in sputum scarce/negative patients with suspected PTB. Methods: All patients with a clinical and radiological suspicion of PTB who underwent bronchoscopy between January 2013 and April 2014 were included. The diagnostic efficiencies of Xpert MTB/RIF and microscopy for AFB were compared to culture for Mycobacterium tuberculosis. Results: Thirty nine of 112 patients were diagnosed with culture-positive PTB. Xpert MTB/RIF was positive in 36/39 with a sensitivity of 92.3 % (95 % CI 78–98 %) for PTB, which was superior to that of smear microscopy (41 %; 95 % CI 26.0–57.8 %, p = 0.005). The specificities of Xpert MTB/RIF and smear microscopy were 87.7 % (95 % CI 77.4–93.9 %) and 98.6 % (95 % CI 91.6 %–99.9 %) respectively. Xpert MTB/RIF had a positive predictive value of 80 % (95 % CI; 65–89.9 %) and negative predictive value of 95.5 % (95 % CI 86.6–98.8 %). 3/9 patients with Xpert MTB/RIF positive culture negative results were treated for PTB based on clinical and radiological findings. Conclusion: Xpert MTB/RIF has a higher sensitivity than smear microscopy and similar specificity for the immediate confirmation of PTB in specimens obtained by bronchial washing, and should be utilised in patients with a high suspicion of pulmonary tuberculosis. | en_ZA |
| dc.description.uri | http://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-015-0086-z#Declarations | |
| dc.description.version | Publisher's version | |
| dc.format.extent | 5 pages | en_ZA |
| dc.identifier.citation | Barnard, D. A. et al. 2015. The utility of Xpert MTB/RIF performed on bronchial washings obtained in patients with suspected pulmonary tuberculosis in a high prevalence setting. BMC Pulmonary Medicine, 15:103, doi:10.1186/s12890-015-0086-z. | |
| dc.identifier.issn | 1471-2466 (online) | |
| dc.identifier.other | doi:10.1186/s12890-015-0086-z | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/99795 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | BioMed Central | |
| dc.rights.holder | Authors retain copyright | |
| dc.subject | Pulmonary tuberculosis -- Treatment | en_ZA |
| dc.subject | Mycobacterium tuberculosis | en_ZA |
| dc.subject | pulmonary tuberculosis -- Diagnosis | en_ZA |
| dc.subject | Xpert MTB/RIF | en_ZA |
| dc.title | The utility of Xpert MTB/RIF performed on bronchial washings obtained in patients with suspected pulmonary tuberculosis in a high prevalence setting | en_ZA |
| dc.type | Article | en_ZA |